Spectre of hunger and death looms as Central Asian nation prepares for harsh winter in the months ahead.

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Akbar does not recall the date, but what he cannot forget are the deaths.

On a particularly frigid day last year, at least six children - ranging from one month to five-years-old - froze to death in a camp for the internally displaced people in Charahi Qambar on the outskirts of Kabul.

They were among the 100-odd Afghans who died in the winter of 2012 - one of the harshest in recent memory.

As one of a handful of maleks (leaders) of the camp, Akbar has a particularly deep sense of remorse and feeling of responsbility for the loss of young lives.

"We can't even keep our children alive," he says, looking at the snow-capped Hindu Kush Mountains in the distance.

With winter just weeks away, the challenge to beat the elements and stay alive has once again gained immediacy.

The majority of the 6,000 internally displaced persons (IDPs) in the Charahi Qambar refugee camp had fled violence from southwestern Herat. They all had hoped that moving to the capital would make their lives less imperiled.

But they might have been wrong.

Humanitarian challenges

Though fighting largely dissipates in Afghanistan during the winter months, the cold and snow of each winter bring a whole host of humanitarian challenges to the Central Asian nation.

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Chief among those challenges are malnutrition and food insecurity.

For the seven million Afghans who suffer from food insecurity, the winter represents one of the most trying periods of the year.

“It was very difficult. There was no medicine. There was no food”, says Sharanfar, a 25-year-old Charahi Qanbar resident, reflecting on past winters.

Sharanfar, who has spent eight winters in the capital since fleeing her home in the Helmand town of Gereshk, says every year it’s the same struggle.

The children, she says, “died because it was cold and they didn’t eat. So they were weak”.

Experts say Sharanfar’s simple explanation is not far from the truth, and given that there are 500,000 IDPs, the scale of the annual scourge is huge.

Christine Roehrs, spokeswoman for Save the Children in Afghanistan, says the winter creates an "evil combination" of weak adults and weak children, who didn't have the chance to nourish themselves properly, being "attacked by the cold".

Food security

For Afghanistan, a volatile mix of a three decades-long conflict, a subsequent population boom and a series of natural disasters (2011 saw the eighth drought in 11 years) have led to a situation where one-third of the population lack access to healthful food.

Another 8.5 million people are on the verge of food insecurity.

In rural areas, the extreme weather of the winter months – mid-November to late March – makes it more devastating.

"What happened last year was a preventable tragedy, and should act as a sharp reminder that emergency assistance must be provided immediately before the winter arrives"

Nicholas Hutchings, deputy director of Afghanaid, which focuses on development in rural areas, uses the central province of Ghor as an example of a community where severe food insecurity is leading to serious health risks.

Each year as heavy snowfall causes temperatures to plummet, the mountainous province is rendered virtually inaccessible for up to four months at a time, Hutchings told Al Jazeera.

“The most vulnerable and food insecure households do whatever they can in order to survive. Those that were lucky enough to own assets such as livestock and furniture sell them before winter in order to purchase whatever food they can during the lean months when no crops can be grown”.

For others, the winter means a concerted reduction in food intake by cutting the number of daily meals or limiting the types of food.

“Many survive on just bread and tea”, Hutchings says.

Even residents of the capital, where the average January temperature is zero degrees celcius, are not spared from the forced cutbacks.

“We just ate chai [tea]. Can you imagine chai for dinner?” Sharanfar says in exasperation.

Save the Children's Roehrs says the malnutrition is especially apparent in children and she can't erase from her memory a child she saw in the northern Jowzjan province.

"Afghanistan is no Horn of Africa, but she looked tiny and bird-like. At 2.6 kilogrammes she had the weight of a newborn baby in Germany," Roehrs says of the girl named Malika.

Making matters worst are the camps for the IDPs which are mostly "open areas" dotted by hundreds of simple tents.

"It is very difficult to survive in the cold in these tents ... These [people] need proper shelter, warmth, education, warm clothing, nutrition and health support", a spokesman for the Aschiana Foundation, an organisation that works for street children, said.

Climactic cycle

But the melting of the snow, which can reach up to 13 feet, does not signal the end of the difficulties. The pools of melted snow turn to flood waters.

Last May, thousands in the northern provinces of Sar-e-Pol and Takhar were left homeless by floods that killed 21.

The north of Afghanistan is made up of nine provinces

This climactic cycle, says Hutchings, is exacerbated by political and financial neglect as international donors often focus on areas in the south where foreign forces are stationed.

Each year Afghanistan’s humanitarian community prepares so-called winterisation efforts to help the most vulnerable households cope – providing basics such as: blankets, fuel and foods that can be stored for long periods.

This October was no different, when more than 28 international organisations met to call for urgent action to prevent a recurrence of winter deaths.

"What happened last year was a preventable tragedy, and should act as a sharp reminder that emergency assistance must be provided immediately before the winter arrives," Polly Truscott, deputy director of Amnesty International's Asia-Pacific programme, said.

But Akbar sees little value in short-sighted aid.

“What is some boxes of milk and some small pieces of bad wood going to do? It does not help when it is so cold for months".

Sharanfar says the United Nations High Commissioner on Refugees, and private donors do come to the Charahi Qambar camp, but the sporadic visits have little impact on daily life.

“They only come sometimes. They come in the winter. And they give us so little. Maybe a little bit of oil, rice, sometimes a little bit of meat. It is so little. It is only during Ramadan or in the winter. But we are hungry all the time.”

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